Organization
CONCIERGE SURGICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SHAUN LEA CRNA (CRNA)
(805) 474-6383
Entity
Organization
Contact information
Practice address
860 OAK PARK BLVD, STE 102, ARROYO GRANDE, CA 93420-1800
(805) 474-6383
Mailing address
860 OAK PARK BLVD, STE 301, ARROYO GRANDE, CA 93420-1800
(805) 474-6383
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
57590
CA
Other
Enumeration date
04/28/2017
Last updated
12/20/2017
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